Yee Carol Ling Sze, Pal Raj P, Batchelder Andrew, Khan Masood A
Department of Urology, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK.
Urol Int. 2012;88(2):165-9. doi: 10.1159/000333046. Epub 2012 Jan 10.
The aim of this study was to determine the incidence of erectile dysfunction and retrograde ejaculation following thulium:yttrium-aluminium-garnet (Tm:YAG) laser prostate vaporesection (ThuVaRP).
Between January 2009 and June 2010, 113 consecutive patients underwent ThuVaRP for bladder outflow obstruction. Of these, 54 (48%) were included in the study as they were able to maintain an erection for sexual intercourse prior to undergoing ThuVaRP. All patients had benign pathology and had not undergone previous bladder neck surgery. The incidence of erectile dysfunction and retrograde ejaculation was reported at a mean follow-up period of 12 months post-operatively.
The mean patient age was 71 years (range 46-90). The mean follow-up period was 12 months (range 4-21). 11 (20%) patients experienced worsening erectile function with 3 (6%) noticing an improvement. A total of 30 patients (56%) experienced some degree of retrograde ejaculation. 4 patients (7%) noticed an improvement in their ejaculation. Retrograde ejaculation was more common in patients with an indwelling catheter in situ for refractory urinary retention (43 vs. 17%, p = 0.04) and in diabetic patients (27 vs. 4%, p = 0.03). There was an increased trend of erectile dysfunction in men aged ≥70 years, with hypertension and with hypercholesterolaemia, but this was not significant.
Our retrospective study has demonstrated that the overall risk of erectile dysfunction and retrograde ejaculation associated with ThuVaRP is 20 and 56%, respectively.
本研究旨在确定钬：钇铝石榴石（Tm:YAG）激光前列腺汽化切除术（ThuVaRP）后勃起功能障碍和逆行射精的发生率。
2009年1月至2010年6月期间，113例因膀胱出口梗阻连续接受ThuVaRP手术的患者。其中，54例（48%）因在接受ThuVaRP手术前能够维持勃起进行性交而被纳入研究。所有患者均为良性病变，且此前未接受过膀胱颈部手术。术后平均随访12个月时报告勃起功能障碍和逆行射精的发生率。
患者平均年龄为71岁（范围46 - 90岁）。平均随访期为12个月（范围4 - 21个月）。11例（20%）患者勃起功能恶化，3例（6%）患者勃起功能改善。共有30例患者（56%）经历了某种程度的逆行射精。4例患者（7%）射精情况有所改善。对于因难治性尿潴留留置导尿管的患者（43%对17%，p = 0.04）以及糖尿病患者（27%对4%，p = 0.03），逆行射精更为常见。≥70岁、患有高血压和高胆固醇血症的男性勃起功能障碍有增加趋势，但不显著。
我们的回顾性研究表明，与ThuVaRP相关的勃起功能障碍和逆行射精的总体风险分别为20%和56%。
